Organization
17 EAGLE VILONIA PROFESSIONAL LLC
Active
Other names
Lane Family Dentistry
Organization subpart
No
Provider details
NPI number
Authorized official
ASHLEY FORSYTH (PAYOR RELATIONS)
(501) 796-3903
Entity
Organization
Contact information
Practice address
17 EAGLE PARK DR, VILONIA, AR 72173-9050
(501) 796-3903
Mailing address
17 EAGLE PARK DR, VILONIA, AR 72173-9050
(501) 796-3903
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
07/07/2025
Last updated
07/07/2025
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